Individual
JUSTIN GALLETLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2409 N COLUMBIA PL, TULSA, OK 74110-2209
(405) 863-1768
Mailing address
2409 N COLUMBIA PL, TULSA, OK 74110-2209
(405) 863-1768
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
10/18/2025
Last updated
10/21/2025
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